| Standard clinical practice underestimates the role and significance of erythropoietin deficiency in sickle cell disease. | |
| | |
MedLine Citation:
|
PMID: 21418176 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
In sickle cell disease (SCD), vigorous reticulocytosis is required to partially compensate for chronic hemolytic anaemia. Consequently, early renal damage, insufficient to cause azotemia but sufficient to cause erythropoietin deficiency and chronic relative reticulocytopenia (chRR), could have severe clinical consequences. chRR was defined as reticulocytes <250 × 10(9) /l despite haemoglobin <9 g/dl on ≥ two occasions ≥4 weeks apart. The influence of multiple variables including chRR on time from first clinic visit to death was evaluated in 306 SCD patients. In univariate analyses, fetal haemoglobin, indices of renal damage (serum creatinine, proteinuria), chRR and age, were associated with rate of death. In multivariate analysis, only age and chRR (Hazard ratio 3·6, 95% CI 2·049-6·327, P < 0·0001) were significant, underlining that chRR could be an early and important clinical consequence of renal damage. Even in chRR patients with normal serum creatinine levels, low haemoglobin and low reticulocyte counts were associated with low erythropoietin levels. In the general population, evaluation of erythropoietin levels is prompted by the combination of anaemia and abnormal serum creatinine. In SCD patients, this standard approach can miss a substantial risk factor for early death. chRR could be a practical and important criterion for diagnosis of erythropoietin deficiency in SCD. |
| | |
Authors:
|
Santosh Saraf; Mohammed Farooqui; Giovanni Infusino; Bharvi Oza; Seema Sidhwani; Michel Gowhari; Stephen Vara; Weihua Gao; Lani Krauz; Donald Lavelle; Joseph Desimone; Robert Molokie; Yogen Saunthararajah |
Related Documents
:
|
10321756 - Intestinal permeability and liver disease. 22482896 - [angle-closure glaucoma secondary to topiramate use]. 6875016 - Changes in the paneth cell population of human small intestine assessed by image analys... 5090866 - Abortion studies in patients with "intraabdominal ileostomy reservoirs" and in patients... 2791786 - Surgical management of anorectal fistulas in crohn's disease. 350906 - Control of plaque by non-chemical means. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-3-21 |
Journal Detail:
|
Title: British journal of haematology Volume: - ISSN: 1365-2141 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
|
Created Date: 2011-3-22 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0372544 Medline TA: Br J Haematol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
© 2011 Blackwell Publishing Ltd. |
Affiliation:
|
Department of Medicine, University of Illinois, Chicago Center for Clinical and Translational Research, University of Illinois, Chicago, IL Department of Hematologic Malignancies and Blood Disorders, Cleveland Clinic, OH, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Genetic variation in Th1/Th2 pathway genes and risk of non-Hodgkin lymphoma: a pooled analysis of th...
Next Document: Integrated profiling of diffuse large B-cell lymphoma with 7q gain.